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  <title>供应商加盟</title>
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<header class="app-reg-head text-center">
  <a href="javascript:" class="logo">
    <img src="../../img/qb.jpg" alt="logo" width="100">
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<section class="bg-w border-tb p20">
  <div class="container">
    <ul class="row">
      <li class="col-sm-3 text-center app-reg-hi">
        <i class="fa fa-home fa-fw fa-4x"></i>
        <h3>申请入驻</h3>
        <p>联系我们，提交申请，审核通过</p>
      </li>
      <li class="col-sm-3 text-center app-reg-hi">
        <i class="fa fa-newspaper-o fa-fw fa-4x"></i>
        <h3>签订协议</h3>
        <p>签订合作，双方约定，互签协议</p>
      </li>
      <li class="col-sm-3 text-center app-reg-hi">
        <i class="fa fa-user fa-fw fa-4x"></i>
        <h3>开通账号</h3>
        <p>签订合作，双方约定，互签协议</p>
      </li>
      <li class="col-sm-3 text-center app-reg-hi">
        <i class="fa fa-cog fa-fw fa-4x"></i>
        <h3>产品上线</h3>
        <p>产品准备，提交审核，产品发布</p>
      </li>

    </ul>
  </div>
</section>

<section class="app-reg-con container">

  <h3>公司信息</h3>
  <article class="panel form-horizontal admin-form border">
    <div class="panel-heading">选择供应商类型时，三类中必须至少选择一类</div>
    <div class="panel-body">
      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">子平台旅行社</label>
        <div class="col-sm-8">
          <p class="form-control-static text-muted">山西东方国际旅行社有限公司</p>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">公司名称</label>
        <div class="col-sm-6">
          <input type="text" id="inputStandard" class="form-control" placeholder="必须与营业执照上一致" required>
        </div>
        <div class="col-sm-2">

          <div class="option-group field">
            <label class="option option-success app-radio">
              <input type="checkbox" name="df">
              <span class="checkbox"></span> 分公司</label>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">品牌名称</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="同业合作品牌名称，如“环宇假期”" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">公司地址</label>
        <div class="col-sm-8 displayt">
          <div class="cell">
            <select class="form-control">
              <option>国家</option>
              <option>Option 2</option>
              <option>Option 3</option>
            </select>
          </div>
          <div class="cell">
            <select class="form-control">
              <option>省份</option>
              <option>Option 2</option>
              <option>Option 3</option>
            </select>
          </div>
          <div class="cell">
            <select class="form-control">
              <option>市</option>
              <option>Option 2</option>
              <option>Option 3</option>
            </select>
          </div>
          <div class="cell">
            <input type="text" id="inputStandard" class="form-control" placeholder="街道地址" required>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">旅游类供应商</label>
        <div class="col-sm-8">
          <div class="option-group field">
            <label class="switch switch-primary ver12">
              <input type="checkbox" name="remember" id="remember" checked="">
              <label for="remember" data-on="是" data-off="否"></label>
            </label>

            <label class="option option-primary app-radio">
              <input type="radio" name="payment" checked>
              <span class="radio"></span>国内社</label>
            <label class="option option-primary app-radio">
              <input type="radio" name="payment">
              <span class="radio"></span>出境社</label>
            <label class="option option-primary app-radio">
              <input type="radio" name="payment">
              <span class="radio"></span>赴台社</label>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">酒店类供应商</label>
        <div class="col-sm-8">
          <div class="option-group field">
            <label class="switch switch-primary ver12">
              <input type="checkbox" name="sdf" id="sdf" checked="">
              <label for="sdf" data-on="是" data-off="否"></label>
            </label>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">玩乐类供应商</label>
        <div class="col-sm-8">
          <div class="option-group field">
            <label class="switch switch-primary ver12">
              <input type="checkbox" name="fdfs" id="fdfs" checked="">
              <label for="fdfs" data-on="是" data-off="否"></label>
            </label>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">结算周期</label>
        <div class="col-sm-8">
          <select class="form-control">
            <option>T+6</option>
            <option>T+20</option>
            <option>Option 3</option>
          </select>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">主营业务产品线</label>
        <div class="col-sm-8">
          <input type="search" id="search" class="form-control" placeholder="关键字检索" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">邮政编码</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="邮政编码" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">固定电话</label>
        <div class="col-sm-8 displayt">
          <div class="w90 cell">
            <input type="number" class="form-control" value="" placeholder="+86" required>
          </div>
          <div class="w90 cell">
            <input type="number" class="form-control" placeholder="区号" required>
          </div>
          <div class="cell">
            <input type="number" class="form-control" placeholder="电话号" required>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">公司邮箱</label>
        <div class="col-sm-8">
          <input type="email" id="inputStandard" class="form-control" placeholder="公司邮箱" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">加盟协议</label>
        <div class="col-sm-3">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
          <a href="javascript:" class="btn btn-success"><i class="fa fa-cloud-download fa-fw"></i>下载合作协议</a>
        </div>
        <div class="col-sm-5">
            <label for="inputStandard" class="col-sm-3 control-label">协议有效期</label>
            <div class="displayt">
              <div class="cell">
                <input type="text" class="form-control" placeholder="" required>
              </div>
              <div class="cell">
                <input type="text" class="form-control" placeholder="" required>
              </div>
            </div>
        </div>
      </div>

    </div>
  </article>

  <h3>联系人信息</h3>
  <article class="panel form-horizontal admin-form border pt20">
    <div class="panel-body">

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">姓名</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="姓名" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">手机号</label>
        <div class="col-sm-8 displayt">
          <div class="cell w90">
            <input type="number" class="form-control" placeholder="区号" required>
          </div>
          <div class="cell">
            <input type="number" class="form-control" placeholder="电话号" required>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">邮箱</label>
        <div class="col-sm-8">
          <input type="email" id="inputStandard" class="form-control" placeholder="邮箱" required>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">QQ</label>
        <div class="col-sm-8">
          <input type="email" id="inputStandard" class="form-control" placeholder="QQ">
        </div>
      </div>

    </div>
  </article>

  <h3>公司资质</h3>
  <article class="panel form-horizontal admin-form border pt20">
    <div class="panel-body">

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">营业执照</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="营业执照号" required>
        </div>
        <div class="col-sm-5">
          <label for="inputStandard" class="col-sm-3 control-label">有效期</label>
          <div class="displayt">
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">营业执照扫码件</label>
        <div class="col-sm-3">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">经营许可证</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="证件号" required>
        </div>
        <div class="col-sm-5">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">责任保险单</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="单号" required>
        </div>
        <div class="col-sm-5">
          <label for="inputStandard" class="col-sm-3 control-label">有效期</label>
          <div class="displayt">
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">责任保险扫描件</label>
        <div class="col-sm-3">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">法人身份证</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="证件号" required>
        </div>
        <div class="col-sm-5">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>正面上传</a>
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>反面上传</a>
        </div>
      </div>

    </div>
  </article>

  <h3>分公司资质</h3>
  <article class="panel form-horizontal admin-form border pt20">
    <div class="panel-body">

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">分公司营业执照</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="营业执照号" required>
        </div>
        <div class="col-sm-5">
          <label for="inputStandard" class="col-sm-3 control-label">有效期</label>
          <div class="displayt">
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
            <div class="cell">
              <input type="text" class="form-control" placeholder="" required>
            </div>
          </div>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">分公司营业执照扫描件</label>
        <div class="col-sm-3">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">旅行社备案登记证</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="证件号" required>
        </div>
        <div class="col-sm-5">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">负责人身份证</label>
        <div class="col-sm-3">
          <input type="text" class="form-control" placeholder="证件号" required>
        </div>
        <div class="col-sm-5">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>正面上传</a>
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>反面上传</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">市场授权书扫描件</label>
        <div class="col-sm-3">
          <a href="javascript:" class="btn btn-warning"><i class="fa fa-cloud-upload fa-fw"></i>上传扫描件</a>
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">被授权人</label>
        <div class="col-sm-8 displayt">
          <div class="cell w160">
            <input type="text" class="form-control" placeholder="姓名" required>
          </div>
          <div class="cell">
            <input type="text" class="form-control" placeholder="手机号" required>
          </div>
        </div>
      </div>

    </div>
  </article>

  <h3>账户信息</h3>
  <article class="panel form-horizontal admin-form border">
    <div class="panel-heading">
      此银行账户信息为与少掌柜平台签订《合作协议》中的对公账户信息一致的公司公账
    </div>
    <div class="panel-body">

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">开户银行</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="开户银行" required="">
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">开户行地址</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="开户行地址" required="">
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">户名</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="户名" required="">
        </div>
      </div>

      <div class="form-group">
        <label for="inputStandard" class="col-sm-2 control-label">账号</label>
        <div class="col-sm-8">
          <input type="text" id="inputStandard" class="form-control" placeholder="账号" required="">
        </div>
      </div>

    </div>
  </article>
  <div class="app-row-sub">
    <button type="button" class="btn btn-warning btn-lg btn-group-lg w160">提 交</button>
  </div>

</section>




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